<?php
	$this->title('Add Neuropsychological Symptom Entry');
?>

<h3><?=$this->title();?></h3>

<?=$this->form->create($neuropsychologicalSymptomAnswer);?>
<?=$this->form->label('Patient');?>
<?php 
	$patientCollection = array();
	foreach ($patients as $patient) {
		$patientCollection[$patient->id] = $patient->PatID;
	}
?>
<?=$this->form->select('patient_id', $patientCollection);?>
<?=$this->form->label('Attention Impairment');?>
<?=$this->form->select('qnumber1', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Anxiety and/or Panic');?>
<?=$this->form->select('qnumber2', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('\'Brain fog\' and/or Confusion');?>
<?=$this->form->select('qnumber3', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Cognitive Impairment (including forgetfulness)');?>
<?=$this->form->select('qnumber4', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Depression');?>
<?=$this->form->select('qnumber5', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Difficulty Finding Words (loss of verbal fluency)');?>
<?=$this->form->select('qnumber6', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Irritability and/or Anger');?>
<?=$this->form->select('qnumber7', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Memory Loss or Impairment');?>
<?=$this->form->select('qnumber8', array('NA' => 'NA', 'Yes' => 'Yes', 'No' => 'No'));?>
<?=$this->form->label('Global Symptom Rating');?>
<?=$this->form->select('qnumber9', array('NA' => 'NA', 'Better' => 'Better', 'Same' => 'Same', 'Worse' => 'Worse'));?>
<?=$this->form->field('record_date', array('label' => 'Date Given'));?>
<?=$this->form->submit('Save'); ?>
<?=$this->form->end();?>